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Predicting fever response of children with pneumonia treated with antibiotics
Insights
White blood cell (WBC) count over 15,000 and C-reactive protein (CRP) levels predict faster fever resolution in children with pneumonia receiving antibiotics. Bacterial infections also indicated quicker fever reduction.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Medicine
Background:
- Pneumonia is a common childhood illness requiring antibiotic treatment.
- Predicting fever response aids in managing pediatric pneumonia and optimizing antibiotic therapy.
Purpose of the Study:
- To identify predictors of rapid fever resolution in children with pneumonia treated with antibiotics.
- To compare the efficacy of various clinical and laboratory markers in predicting fever response.
Main Methods:
- 156 children diagnosed with pneumonia were assessed.
- Evaluated C-reactive protein (CRP), white blood cell (WBC) count, erythrocyte sedimentation rate (ESR), blood cultures, and viral/mycoplasma titers.
- Clinical follow-up was conducted to monitor fever resolution.
Main Results:
- WBC count ≥ 15,000 and CRP (+) at 1:50 were superior predictors of rapid fever resolution compared to ESR or high temperature.
- WBC ≥ 15,000 demonstrated high sensitivity and specificity for predicting fever resolution within 8, 12, or 24 hours.
- Positive blood or lung bacterial cultures correlated with faster fever resolution, unlike viral or mycoplasma titer increases.
Conclusions:
- Elevated WBC count (≥ 15,000) is a valuable predictor of rapid fever response in pediatric pneumonia patients on antibiotics.
- CRP levels and positive bacterial cultures also assist in predicting fever resolution.
- These markers can guide clinical management and antibiotic treatment strategies.
Abstract:
In order to study predictors of fever response in children with radiologic pulmonary infiltrates treated with antibiotics, 156 children with pneumonia were evaluated with slide test C-reactive protein (CRP), white blood cell count (WBC), erythrocyte sedimentation rate (ESR), blood cultures, acute and convalescent viral and mycoplasma titers, and then followed clinically. Both CRP (+) at a serum dilution of 1:50 and WBC greater than or equal to 15,000 were better predictors of rapid resolution of fever while the patient was receiving antibiotics than were ESR greater than or equal to 30 or temperature greater than or equal to 40 C. WBC greater than or equal to 15,000 was nearly as specific but more sensitive than CRP (+) 1:50 for resolution of fever in either 8, 12 or 24 hours. Positive blood or lung bacterial cultures, but not four-fold or greater viral or mycoplasma titer increases, were also associated with rapid resolution of fever. WBC greater than or equal to 15,000 is useful in predicting rapid fever response in children with pneumonia treated with antibiotics.